[Osseous and soft tissue operations for treatment of joint malpositioning in infantile cerebral palsy].

If untreated infantile cerebral palsy (ICP) leads to a progressive shortening of muscles and to progressive joint malpositioning. In addition a number of other disorders also result, in particular sensory disorders, intelligence deficits and epilepsy. In order to optimally treat as many as possible of the problems of multi-handicapped children with ICP it is of immanent importance that physiotherapists, occupational therapists, speech therapists, orthopedic technicians, pediatric orthopedists as well as neuropediatricians and social pediatricians work as a team. Surgical measures to correct joint malpositioning serve to improve the function and also to avoid or alleviate pain. Functional improvement measures are ideally undertaken during or shortly before elementary school age, thus enabling a further verticalization/straightening and mobilization. To improve symmetry and therefore the sitting posture, surgery is also indicated for profoundly disabled patients, sometimes making foot operations necessary. It is only in this way that maximum participation can be guaranteed and if necessary utilizing additional aids, such as Zimmer frames or E-wheelchairs.